#JAMAClinicalUpdate: Change in the Incidence of Stillbirth a
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High rates of preterm birth and cesarean delivery have been reported in women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, studies have inadequate power to assess uncommon outcomes like stillbirth. The UK Obstetric Surveillance System reported 3 stillbirths among 247 completed pregnancies in women with confirmed coronavirus disease 2019 (COVID-19) vs the national rate. Researchers assessed the change in stillbirth and preterm delivery rates during the pandemic.

They compared pregnancy outcomes at St George’s University Hospital, London. Outcomes included stillbirth, preterm birth, cesarean delivery, and neonatal unit admission. Group comparisons were made using Mann-Whitney and Fisher exact tests. There were 1681 births (1631 singleton, 22 twin, and 2 triplet pregnancies) in the pre-pandemic period and 1718 births (1666 singleton and 26 twin pregnancies) in the pandemic period. There were fewer nulliparous women in the pandemic period than in the pre-pandemic period and fewer women with hypertension in the pandemic period than the pre-pandemic period, and there were no significant differences in other maternal characteristics.

The incidence of stillbirth was significantly higher during the pandemic period; none associated with COVID-19 than during the pre-pandemic period, and the incidence of stillbirth was significantly higher when late terminations for fetal abnormality were excluded during the pandemic period. There were no significant differences over time in births before 37 weeks’ gestation, births after 34 weeks’ gestation, neonatal unit admission, or cesarean delivery.

This study demonstrates an increase in the stillbirth rate during the pandemic. A direct consequence of SARS-CoV-2 infection is possible. Although none of the stillbirths in the pandemic period were among women with COVID-19, surveillance studies in pregnant women reported that as much as 90% of SARS-CoV-2–positive cases were asymptomatic.

Source: https://jamanetwork.com/journals/jama/fullarticle/2768389
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